Introduction:To evaluate efficacy and safety of Botulinum Toxin A (Botox) injection in the detrusor for day-time lower urinary tract conditions with mainly overactive symptoms, we analyzed our uropediatric Botox-treated collective. Materials and Methods:21 Children who received a Botox treatment in our hospital between 2016 and 2020 for refractory day-time lower urinary tract conditions with mainly overactive symptoms with conclusive follow up were analyzed. In all cases we applicated 100 IU Botox.Results: Mean age of patients was 9,19 (±3,0). In 8/21 cases a preoperative urodynamic assessment was available. We reached a median follow up of 289 days (range 34-750). Mean bladder capacity increased from 157 ml (±18.4) to 213 ml (±24.5) (p = 0.001). Mean voiding frequency decreased from 7.4 (±0.61) to 6.2 (±0.55) (p = 0.015). 13/21 Patients (61.9%) encountered a partial or complete therapy response while 8/21 Children (38.1%) showed a therapy failure. Within the responder group, 8/13 Children (61, 5%) experienced an ongoing response. However, 5 Children relapsed on average in 176 days (±45, 5). 3 Children received a repeated injection of Botox. We observed no serious side effects.Discussion/Conclusion: Even though pediatric Botox therapy still lacks standardization; our study indicates a safe and effective use for day-time lower urinary tract conditions with mainly overactive symptoms in children who are resistant to common treatments. Moreover, we found a one-time injection in most cases to be sufficient to improve symptoms in the long term.